| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
17,101 |
15,869 |
$2.51M |
| 00003 |
Internal/system code - not a standard HCPCS code |
5,386 |
4,779 |
$1.00M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,911 |
7,185 |
$63K |
| 90834 |
Psychotherapy, 45 minutes with patient |
1,359 |
483 |
$53K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
523 |
375 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
499 |
386 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,243 |
4,001 |
$12K |
| 90832 |
Psychotherapy, 30 minutes with patient |
349 |
156 |
$11K |
| V2020 |
Frames, purchases |
808 |
659 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
235 |
159 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
351 |
283 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
509 |
307 |
$5K |
| 92015 |
Determination of refractive state |
981 |
800 |
$4K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
3,413 |
3,156 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,922 |
2,639 |
$3K |
| 99205 |
Prolong outpt/office vis |
21 |
13 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
505 |
265 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,118 |
1,963 |
$1K |
| 99215 |
Prolong outpt/office vis |
487 |
471 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
15 |
$1K |
| 59425 |
|
26 |
19 |
$532.22 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
39 |
25 |
$329.40 |
| H1003 |
Prenatal care, at-risk enhanced service; education |
13 |
13 |
$279.00 |
| G9920 |
Screening performed and negative |
140 |
138 |
$261.05 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
20 |
13 |
$234.64 |
| 87807 |
|
326 |
298 |
$231.39 |
| 81003 |
|
808 |
751 |
$211.00 |
| 92133 |
|
29 |
28 |
$141.60 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
23 |
20 |
$138.76 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
555 |
545 |
$124.65 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
495 |
437 |
$117.40 |
| 92551 |
|
436 |
430 |
$93.50 |
| 99000 |
|
133 |
126 |
$74.28 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
89 |
88 |
$65.80 |
| 85018 |
|
952 |
937 |
$40.59 |
| 81025 |
|
35 |
29 |
$19.60 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
29 |
$18.10 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
29 |
29 |
$10.25 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
27 |
24 |
$5.04 |
| 36416 |
|
982 |
980 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
294 |
294 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
130 |
129 |
$0.00 |
| 96127 |
|
44 |
43 |
$0.00 |
| 3080F |
|
41 |
41 |
$0.00 |
| Z6410 |
|
90 |
46 |
$0.00 |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
14 |
14 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
133 |
73 |
$0.00 |
| 96160 |
|
204 |
163 |
$0.00 |
| 3077F |
|
317 |
305 |
$0.00 |
| 1159F |
|
3,615 |
3,408 |
$0.00 |
| 1160F |
|
3,615 |
3,408 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
31 |
31 |
$0.00 |
| 99173 |
|
452 |
452 |
$0.00 |
| 59426 |
|
20 |
18 |
$0.00 |
| 81002 |
|
25 |
23 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
115 |
115 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
15 |
15 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
16 |
16 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
37 |
$0.00 |
| Z6400 |
|
20 |
20 |
$0.00 |
| 99188 |
|
16 |
16 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
15 |
15 |
$0.00 |